Washington Highlights

December 14, 2012—The AAMC sent a Dec. 10 letter to members of Congress and the administration expressing concern regarding the potential for cuts to Medicare’s support for graduate medical education (GME) and payments for evaluation and management (E/M) services provided in hospital outpatient departments (HOPDs) as part of any deficit reduction plan.

In the letter, AAMC President and CEO Darrell G. Kirch, M.D. specifically points out that cuts to these programs would have a disproportionate impact on major teaching hospitals, which represent only 6 percent of all hospitals. The letter states that “proposals to reduce Medicare GME support, including reductions in Indirect Medical Education (IME) payments, would threaten access to critical services unavailable elsewhere and reduce physician training at a time when patient needs are increasing.”

The letter also highlights the significant difference in the percentage of the HOPD cuts that would come from teaching hospitals compared to other hospitals, which was also recognized by the Medicare Payment Advisory Commission (MedPAC). “[T]his $1 billion a year cut will fall disproportionately on the teaching hospitals, upon which these patients depend. Cuts to teaching hospitals will exceed $738 million annually, including nearly $454 million from major teaching hospitals, which account for only 6 percent of all U.S. hospitals.”

Finally, the letter urges Congress to continue its recognition of the “legitimate, higher costs of providing care in teaching hospital outpatient departments and the disproportionate effects that facility fee reductions would have on access to care. Moreover, these cuts also will jeopardize the training of health professionals in outpatient settings.”